Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension (“adaptive salience”). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL.

中文翻译：

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寻求帮助的青年快感缺失、强化学习和全球功能之间的关系

显着性信号传导的神经回路功能障碍与精神病症状有关，并可能预测精神病临床高危 (CHR) 青年转变为精神病性障碍。此外，阴性症状的严重程度，包括快感缺乏的完成和预期方面，可以预测精神分裂症谱系障碍患者的功能结果。然而，目前尚不清楚快感缺乏是否与将激励显着性归因于刺激的能力有关（通过强化学习 [RL]），以及快感缺乏和 RL 的测量是否可以预测更年轻、寻求帮助的人群的功能结果。我们对 33 名符合 CHR 或新发精神病性障碍标准的参与者和 29 名患有非精神病性障碍的求助青年进行了显着性归因测试 (SAT)。在SAT考试中，参与者必须识别相关和不相关的刺激维度，并对相关维度的 2 个级别的不同强化概率敏感（“自适应显着性”）。自适应显着性归因与完整样本中的完美愉悦和功能正相关。分析还揭示了适应性显着性对完成快感与角色（αβ = .22, 95% CI = 0.02, 0.48）和社会功能（αβ = .14, 95% CI = 0.02, 0.30）之间的关系的间接影响。这些研究结果表明，通过受损的奖励敏感性和 RL，导致寻求帮助的青年全球功能不佳的独特途径。自适应显着性归因与完整样本中的完美愉悦和功能正相关。分析还揭示了适应性显着性对完成快感与角色（αβ = .22, 95% CI = 0.02, 0.48）和社会功能（αβ = .14, 95% CI = 0.02, 0.30）之间的关系的间接影响。这些研究结果表明，通过受损的奖励敏感性和 RL，导致寻求帮助的青年全球功能不佳的独特途径。自适应显着性归因与完整样本中的完美愉悦和功能正相关。分析还揭示了适应性显着性对完成快感与角色（αβ = .22, 95% CI = 0.02, 0.48）和社会功能（αβ = .14, 95% CI = 0.02, 0.30）之间的关系的间接影响。这些研究结果表明，通过受损的奖励敏感性和 RL，导致寻求帮助的青年全球功能不佳的独特途径。